Heart Disease: The hidden picture

Being in Northern England can be terrible for your health, at least if NHS data data released by the health charity Heart UK is to be believed.

Indeed, the top three highest death rates from heart conditions are the Northwest, with 93.72 deaths per 100,000; Yorkshire and the Humber with 88.9 deaths and the North East with 87.46 percent.

The three places with the lowest death rates were, meanwhile in the South, namely the South West (67.74), South East Coast (67.02) and South Central (65.59).

This is, of course, both good news and bad news for older people. Of all deaths that befall the 55-74 age group, 24.4% are caused by heart disease amongst men, and 14.2% amongst women, making it the second biggest killer after cancer.

But why the North? History gives some of the answers. On the one hand, the old industries of the North were strenuous, unhealthy and unrelenting, and generally not good for you. Nor, however, was the wave of mass unemployment that followed the breakup of these industries during the 80s. Sedentary lifestyles combined with chronic health complaints are, to state the obvious, not good for your health.

There are variations in diet too. There may be a cultural inclination in the North towards eating less fruit and vegetables, drinking to excess and not cutting down on fat (and, as increasingly recognised, refined carbohydrates), though this does not tell the whole picture. Having the time and resources to take regular vigorous exercise is also important, and again it is the South that tends towards having these advantages.

For as science commentator Ben Goldacre has observed, it's your socio-economic class and environment that have the most effect on your life expectancy, with the average income of your area directly paralleling your life expectancy and so your likelihood of dying from heart disease.

But the real picture is much more complex. London, in the south but around average in life expectancy, has both some of the longest lived people in the UK (Kensington & Chelsea, with life expectancies of 89 for women and 84.4 for men) and some of the shortest lived (Wandsworth, with life expectancies of 82.1 for women and 77.8 for men), all within easy walking distance of one another.

Meanwhile in the North, there are certainly health black spots like Blackpool (with life expectancies of 79.4 for women and 73.7 for men), but nearby North Yorkshire and York have above-UK average life expectancies of 83.1 for women and 79.4 for men. Right next door to North Tyneside, with a grim life expectancy of 76.8 for men, is Northumberland, with an altogether better male life expectancy of 78.5.

The truth of the matter is that there are large areas of the North where average health is rather good and parts of the South that are in poor health, generally speaking. Tellingly, those places that have lower life expectancies (and so higher rates of heart disease and premature death) tend to be in run-down, urban areas, while those areas that do well are either very wealthy or rural and semi-urban, and have not seen major declines in employment and job prospects.

After all, beyond England, there are whole swathes of post-industrial Wales and Glasgow that show all the tell-tale signs of poor diet and poorer prospects. Poverty and poor health are natural bedfellows.

This is why 'North and South' is misleading, a distraction from the real issue; England and the UK being hidebound by social and class issues that undermine and prematurely end the lives of entire communities.